You are to select and interview a professional in the medical field. You are to complete the interview in person or by phone. At the beginning of the interview, you will explain the P.R.I.C.E. elements to the interviewee and then ask these questions:

• Have you seen the impact of applying these elements in your career?
• Which element(s) is/are the most important in your career field?
• In what situations are these elements the most challenging to utilize?
• Would you add or subtract from this list of elements if you could?
• Do you feel these elements are applicable for careers in this field in the future?

While you have been given the questions for the interviewee to answer, you still need to take some time to be prepared in advance of the interview.  Be sure to either take notes during the interview or ask permission and tape responses so you can remember what was said while completing the Unit 1 worksheet.

Be sure to complete the Unit 1 worksheet.

Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.

What has your experience been with patient involvement in treatment or healthcare decisions?

In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.

To Prepare:

• Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.
• Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/.
  • Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.

NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.

Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life. 

Resources:

1. Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186

 Note: You will access this article from the Walden Library databases.

2. Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44(1), 188–201. doi:10.1097/CCM.0000000000001396

Note: You will access this article from the Walden Library databases.

3. Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32(4), 176–184. doi:10.1097/NND.0000000000000483

Note: You will access this article from the Walden Library databases.

4. Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.x

Note: You will access this article from the Walden Library databases.

1-Suppose you were planning to conduct a statewide study of the work plans and intentions of nonemployed registered nurses in your state. Would you ask mostly open-ended questions or closed-ended questions? Defend your answer.

2- APA style

3- 3 paragraphs of 3 sentences each

4- 2 references

This week we are move to learning more about the influences of social determinants of health and the impact of illnesses on population health.  I wanted to include a prezi presentation on social determinants of health to help add to your learning experience.  This presentation ( https://prezi.com/view/nw4a58n819Nci6P2wScA/ ) will give you an outline of the following:  

Social determinants of health (SDOH) and Outcomes: 

·  Defining SDOH and health disparities

·  Outlining the 5 key components of SDOH and impact on health and illness 

·  Timeline view of policies encacted to address health disparities and access to care

Community Health Assessment:

·  Call to Action- an assessment of resources in a county (Mecklenburg County, North Carolina-geopolitical/phenomenological), stakeholders (advisory committee), interventions by health care organizations (community resource) to combat health disparities 

·  Comparison of policies at competing organizations for recommending policy change

Recommendation:

·  In this presentation a model of care was utilized to help prioritize care and needs assessment

·  Healthcare organization in this presentation offers access to hospital and primary care services

·  Healthcare organization policy recommendation to revise policy to reach the masses of patients that fall in the gap still needing access to health care

This presentation is a supplement to your text.  It is optional to view, and post a substantive response for participation credit.  The idea of the presentation is to bridge the gap of last week’s lesson and introduce this week’s lesson.  Please remember to read and use your book and supplemental resources in the syllabus as a resource for learning.  As always, I am here as a resource as well.  

Wednesday 23

Imagine that, for about a year, your nursing unit has been involved in an intensive campaign to improve patient satisfaction scores with pain management. You are getting good data from your patients, as the length of stay on this inpatient geriatric medical nursing unit is only about 6 days. Your hospital does 100% survey to inpatients, and the response rate is about 25%, which is higher than it has been. This notwithstanding, the percent of “patient very satisfied” (top box), with a score of 5, has been in the low 70s. The national benchmark for medical surgical units like yours is about 85% very satisfied. Of all the units in your hospital, your unit is the lowest scoring on this HCAPHS survey. But as your unit is the only geriatric medical nursing unit in the hospital, you’d always thought it was the nature of the patient population.
You have been the day shift representative to the QI team, and the scores on your unit are posted monthly. Here are the numerous strategies that have been tried on your unit and the timeframes.

Document: Strategies and Interventions (PDF)–attached below

For this Discussion, examine the strategies and interventions tried in your unit and consider the following questions: a) Were the strategies effective in creating a sustainable change on your nursing unit, and b) To what extent can your nurse manager and CNO count on your unit exceeding the national benchmark in the next quarter, the next year? That is, does this run chart have some predictive ability? Does the run chart support the nursing unit’s decision to celebrate? To what extent can the leadership be confident that the trend will continue?

By Day 3

Based on the scenario, explain what was done successfully and where improvement was needed in the quality improvement process. Identify the performance improvement tools, and explain how they contributed to the outcome.

Support your response with references from the Resources and professional nursing literature. Your posts need to be written at the capstone level (see checklist).

This wks resources attached and follow:

https://support.microsoft.com/en-gb/office/use-charts-and-graphs-in-your-presentation-c74616f1-a5b2-4a37-8695-fbcc043bf526?ui=en-us&rs=en-gb&ad=gb

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old). (Refer to AWE Checklist, Capstone)

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

• Review the Resources and select one current national healthcare issue/stressor to focus on.
• Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

By Day 3 of Week 1

Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

By Day 6 of Week 1

Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

Will be adding two discussions that will need at least three references all in APA 7 format each. will be included in this payment.

The mail discussion will need at least 3 references and also in APA 7 format

Adams Discussion

Current Healthcare Issue

National Healthcare Stressor

The last decade in healthcare has been volatile at best with the adoption of the Affordable Care Act (ACA) and performance-based payment systems, the ever-increasing polar divide between our political party’s healthcare theories and the never ending back and forth political discord that threatens to blow it all up and start over with something better, but never explained in detail. One of the constants that I continue to see is the increase in psychiatric patients coming into the hospital that I work. A number of these patients are undiagnosed with a psychiatric diagnosis or cannot find a provider that is seeing new patients. Many providers that are seeing new patients currently have wait times four weeks out. Someone that is experiencing psychiatric symptoms this wait could have a derailing effect on the efficacy of the treatment.  

The number of patients needing psychiatric treatment in the United States is increasing and roughly one-third of the 10 million Americans are diagnosed with a psychiatric disorder but not getting treatment. (Olfson, 2016) One of the reasons for this is the lack of providers in the psychiatric specialty. With reimbursement rates falling lower than many other specialty services many institutions are struggling to cover salaries. With more than 60% of current providers aged 55 years or greater, this is also adding to the decreasing numbers. Another factor, is the increase in acceptability in discussing mental health issues and seeking out treatment. According to Weiner, (2018), with more patients seeking treatment, current providers are unable to increase their treatment numbers. 

Impact on work setting

The institution that I work at is a safety net hospital that provides medical and social care to a population where 70% live at or below the poverty line. Many of these patients have undiagnosed or unmanaged psychiatric disorders that provide harm and are a detriment to their medical issues such as diabetes, cardiac issues and COPD. Working nights, I am accustomed to doing more with less. One of the challenges that I face constantly is the lack of psychiatric evaluations once a patient leaves the emergency department. Medical teams are forced to make psychiatric pharmaceutical decisions off the cuff until 7 AM when the psychiatric team rounds on a particular patient. This is particularly difficult on patients and staff alike.

Respondence to the issue

To create a discussion on this our staff used our unit council to speak to the Director of Critical Care, Nursing and Medicine, inviting the Psychiatric department to our monthly unit council meeting in hopes to better understand why this was not a priority as well as speaking to the Vice President of Nursing and the Medical Director about the importance of psychiatric services outside the emergency room on a 24 hour basis. After years of voicing concerns to upper Medicine and Nursing Management our institution increased inpatient psychiatric coverage to 24 hours per day.  Patients in need of psychiatric evaluations who have made in past the emergency room have an opportunity to be treated when they arrive on our unit. Our ICU team now has a partner when questioning what type of medication to give an irate patient who is a danger to himself or others. This intervention exemplifies the use of the quadruple aim approach with its increase in global health, improving patient experience, lowering costs and improving work-life for our staff. (Jacobs et al., 2018)

References:

Jacobs, B., Heinmiller, J., McGovern, J., & Drenkard, K. (2018). Engaging Employees in Well-Being: Moving From the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3). https://doi.org/10.1097/NAQ.0000000000000303

Olfson, M. (2016). Building The Mental Health Workforce Capacity Needed To Treat Adults With Serious Mental Illnesses. Health Affairs, 35(6), 983–990. https://doi.org/10.1377/hlthaff.2015.1619

Weiner, S. (2018, February 12). Addressing the escalating psychiatrist shortage. AAMC. https://www.aamc.org/news-insights/addressing-escalating-psychiatrist-shortage.

Rebeccas Discussion

Review of Current Healthcare Issues
 

National Healthcare Issue/Stressor 

        Healthy People is a set of strategic goals released by the U. S. Department of Health and Human Services designed to measure progress toward

specific health objectives aimed at enabling people to live long and healthy lives. Healthy People 2020 is the fourth Healthy People initiative released.

 It includes the goal of improving mental health through prevention and by ensuring access to appropriate, quality mental health services (Healthy

People, 2020).  Mental health disorders such as anxiety, depression, and substance abuse are increasing in prevalence and most cases of mental

illness occur earlier in life. The disease burden and costs associated with untreated or under-treated mental health disorders are rapidly increasing.

Mental health disorders are a common cause of disability and suicide is the 10th leading cause of death in the U.S. In addition, our country will see a

heavier mental health burden due to the COVID-19 pandemic (Stephenson, 2020). Therefore, it is crucial to include mental health objectives in the

Healthy People goals, to measure our progress, and to recognize the importance of meeting these goals.    

Impact on Work Setting  

        Currently, I work for a large health insurance company where I conduct medical necessity reviews of behavioral health treatment modalities to

include both inpatient and outpatient care.  Our company has seen sharp increases in the need for behavioral health treatment to include inpatient

mental health stays, inpatient detox stays, partial hospital stays, and intensive outpatient therapy.  More behavioral health clinicians had to be

brought on and trained to meet this current demand. Another impact to my work setting involves the fact that poor mental health has negative

impacts on physical health. Untreated mental illness can lead to chronic diseases which drive up the cost of health care.  Active treatment of mental

health issues, as opposed to prevention and early intervention, is more costly.  

Responding to the issue 

        Our company firmly believes in quality, cost-effective care and awards facilities that meet these milestones.  We continuously assess and update

our guidelines and coverage policies to reflect this. The company recognizes that mental health treatment is not a one-size-fits-all approach.  Recently

we changed guidelines for reviewing substance abuse treatment to the American Society of Addiction Medicine (ASAM) guidelines.  This approach

looks at the whole patient by assessing 6 dimensions that consider a person’s needs and severity of illness to help develop a treatment plan. The

premise is that patients can be assigned to treatments that “yield the best outcomes in the least restrictive and costly settings” (Stallvik et al., para 8).

By reviewing against these guidelines, we are ensuring that patients get the appropriate treatment at the appropriate time.   

        The company has been educating staff on current behavioral health trends, new treatments, and the impact of the COVID pandemic. We have an

active behavioral health case management team that reaches out to patients before, during, and after treatment to ensure they are set up with the

necessary follow up. We encourage and assist patients with finding primary care providers.  Park et al. (2018) state that primary care produces a

higher quality of care, improves access and outcomes, and lowers cost.  Additionally, one of our nurse leaders recently posted an informative series

about the social determinants of health and the importance of helping our patients overcome barriers so they can achieve their best physical and

mental health.  An organization needs effective leaders like this who can bring these issues to the forefront and encourage others to become active

participants in the change process (Broome & Marshall, 2021). The company’s website includes links to many resources such as food pantries, ride-

sharing, and mental health services.  By making this information readily available, we are making efforts to increase prevention and early

intervention. As a whole, I believe the company has responded well to the national healthcare issue of mental illness and I feel confident that we will

continue to look for ways to improve patient access and patient outcomes.  
 

References 

Broome, M., & Marshall, E.S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY:

        Springer.  

Office of Disease Prevention and Health Promotion. (n.d.). Healthy People 2020: Mental health and mental disorders. Retrieved November 28, 2020

        from  https://www.healthypeople.gov/2020/topics-objectives/topic/mental-health-and-mental-disorders 

Park, B., Gold, S.B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the

       Quadruple Aim. Journal of the American Board of Family Medicine, 31(4), 588-604.  

Stallvik, M., Gastfriend, D.R., & Nordahl, H. M. (2015). Matching patients with substance use disorder to optimal level of care with the ASAM Criteria

       software. Journal of Substance Use, 20(6), 389-398.  https://doi.org.ezp.waldenulibrary.org/10.3109/14659891.2014.934305 

Stephenson, J. (2020). CDC report reveals “considerably elevated” mental health toll from COVID-19 stresses. Retrieved November 29, 2020 from

        https://jamanetwork.com/channels/health-forum/fullarticle/2770050 

Search the GCU Library and find two new health care articles that use quantitative research. Do not use articles from a previous assignment, or articles that appear in the Topic Materials or textbook.

Complete an article analysis for each using the “Article Analysis: Part 2” template.

Refer to the “Patient Preference and Satisfaction in Hospital-at-Home and Usual Hospital Care for COPD Exacerbations: Results of a Randomised Controlled Trial,” in conjunction with the “Article Analysis Example 2,” for an example of an article analysis.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Attachments 

2 pages

• Summarize the key points of both structural family therapy and strategic family therapy.
• Compare structural family therapy to strategic family therapy, noting the strengths and weaknesses of each.
• Provide an example of a family in your practicum using a structural family map. Note: Be sure to maintain HIPAA regulations.
• Recommend a specific therapy for the family, and justify your choice using the Learning Resources.Required Readings

helpfull links

McNeil, S. N., Herschberger, J. K., & Nedela, M. N. (2013). Low-income families with potential adolescent gang involvement: A structural community family therapy integration model. American Journal of Family Therapy, 41(2), 110-120. doi:10.1080/01926187.2011.649110

Méndez, N. A., Qureshi, M. E., Carnerio, R., & Hort, F. (2014). The intersection of Facebook and structural family therapy volume 1. American Journal of Family Therapy, 42(2), 167-174.  doi:10.1080/01926187.2013.794046 

Nichols, M., & Davis, S. D. (2020). The essentials of family therapy (7th ed.). Boston, MA: Pearson.
Chapter 4, “Bowen Family Systems Therapy” (pp. 56-71)
Chapter 5, “Strategic Family Therapy” (pp. 72-88)
Chapter 6, “Structural Family Therapy” (pp. 89-104

Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207-215. doi:10.1111/famp.12025

Ryan, W. J., Conti, R. P., & Simon, G. M. (2013). Presupposition compatibility facilitates treatment fidelity in therapists learning structural family therapy. American Journal of Family Therapy, 41(5), 403-414. doi:10.1080/01926187.2012.727673 

Sheehan, A. H., & Friedlander, M. L. (2015). Therapeutic alliance and retention in brief strategic family therapy: A mixed-methods study. Journal of Marital and Family Therapy, 41(4), 415-427. doi:10.1111/jmft.12113

​Szapocznik, J., Muir, J. A., Duff, J. H., Schwartz, S. J., & Brown, C. H. (2015). Brief strategic family therapy: Implementing evidence-based models in community settings. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 25(1), 121-133. doi:10.1080/10503307.2013.856044

TherapistAid. (2020). Genograms for psychotherapy. Retrieved from https://www.therapistaid.com/therapy-guide/genograms

Your Leadership Profile

Do you believe you have the traits to be an effective leader? Perhaps you are already in a supervisory role, but as has been discussed previously, appointment does not guarantee leadership skills.

How can you evaluate your own leadership skills and behaviors? You can start by analyzing your performance in specific areas of leadership. In this Discussion, you will complete Gallup’s StrengthsFinder assessment. This assessment will identify your personal strengths, which have been shown to improve motivation, engagement, and academic self-conference. Through this assessment, you will discover your top five themes—which you can reflect upon and use to leverage your talents for optimal success and examine how the results relate to your leadership traits.

To Prepare:

Complete the StrengthsFinder assessment instrument, per the instructions found in this Module’s Learning Resources.

Please Note: This Assessment will take roughly 30 minutes to complete.

NOTE: Please keep your report. You will need your results for future courses. Technical Issues with Gallup:
If you have technical issues after registering, please contact the Gallup Education Support group by phone at +1.866-346-4408. Support is available 24 hours/day from 6:00 p.m. Sunday U.S. Central Time through 5:00 p.m. Friday U.S. Central Time.

• Reflect on the results of your Assessment, and consider how the results relate to your leadership traits.

By Day 3 of Week 5

Post a brief description of your results from the StrengthsFinder assessment. Then, briefly describe two core values, two strengths, and two characteristics that you would like to strengthen based on the results of your StrengthsFinder assessment. Be specific.

Needs nursing paper done.